Use of human acellular dermal matrix in complex and contaminated abdominal wall reconstructions

Patton, Joe H.; Berry, Stepheny; Kralovich, Kurt A.

doi:10.1016/j.amjsurg.2006.09.021

Cited by 199 publications

(105 citation statements)

References 16 publications

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“…Although a wide variety of biological (21)(22)(23) and synthetic (1,24,25) matrices have been evaluated for their efficacy in tissue repair, their use is limited because of the lack of a blood supply, leading to their necrosis, infection, or possible rejection. In parallel, contemporary surgical techniques exploiting local, regional, or free flaps present disadvantages, such as donor site morbidity, procedure duration, the often scant availability of tissues in the area of the defects, and a requirement for higher surgical skill.…”

Section: Discussionmentioning

confidence: 99%

An engineered muscle flap for reconstruction of large soft tissue defects

Shandalov¹,

Egozi

Koffler

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

137

135

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Significance Effective restoration of large soft tissue defects requires the use of tissue flaps, with viability that is largely determined by degree of vascularization. In view of the tedious transfer procedures and donor site morbidity associated with autologous flaps, this work set out to design and evaluate an engineered muscle flap featuring a robust vascular port formed from preseeded endothelial cells and host vasculature. The implanted flap was highly vascularized, well-perfused, and anastomosed with host vessels. Engineered flaps of this nature promise to circumvent the need to harvest and transfer massive tissue volumes, while avoiding the consequential complications.

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Section: Discussionmentioning

confidence: 99%

An engineered muscle flap for reconstruction of large soft tissue defects

Shandalov¹,

Egozi

Koffler

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

137

135

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“…A variety of materials exist, each with their own advantages and corresponding complications. 26,34,35 In tissue engineering applications, some investigators have reported the successful use of various cells and SIS to restore defects. 36,37 In the present study, we explored the feasibility of seeding tenocytes onto SIS to reconstruct abdominal wall defects in a rat model.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Abdominal Wall Musculofascial Defects with Small Intestinal Submucosa Scaffolds Seeded with Tenocytes in Rats

Song

Peng

Liu

et al. 2013

Tissue Engineering Part A

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The repair of abdominal wall defects following surgery remains a difficult challenge. Although multiple methods have been described to restore the integrity of the abdominal wall, there is no clear consensus on the ideal material for reconstruction. This study explored the feasibility of in vivo reconstruction of a rat model of an abdominal wall defect with a composite scaffold of tenocytes and porcine small intestinal submucosa (SIS). In the current study, we created a 2 · 1.5 cm abdominal wall defect in the anterolateral abdominal wall of SpragueDawley rats, which were assigned into three groups: the cell-SIS construct group, the cell-free SIS scaffold group, and the abdominal wall defect group. Tenocytes were obtained from the tendons of rat limbs. After isolation and expansion, cells (2 · 10 7 /mL) were seeded onto the three-layer SIS scaffolds and cultured in vitro for 5 days. Cell-SIS constructs or cell-free constructs were implanted to repair the abdominal wall defects. The results showed that the tenocytes could grow on the SIS scaffold and secreted corresponding matrices. In addition, both scaffolds could repair the abdominal wall defects with no hernia recurrence. In comparison to the cell-free SIS scaffold, the composite scaffold exhibited increased vascular regeneration and mechanical strength. Furthermore, following increased time in vivo, the mechanical strength of the composite scaffold became stronger. The results indicate that the composite scaffold can provide increased mechanical strength that may be suitable for repairing abdominal wall defects.

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“…This infection rate is comparable to rates reported by similar studies of complex hernia repairs with high risk of infection, ranging from 16% to 25% in published reports. 19,21 Interestingly, the infection rate increased little when stratified by grade: 17%, 24%, and 22% for grades 2, 3, and 4, respectively. Differences between grades were not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…Elevated risk of infection is a reasonable contraindication to the implantation of synthetic repair materials, whereas biological materials such as noncrosslinked PADM have been shown to develop a vascular supply and thus more reliably resist infection. 9,13,15,[17][18][19][20][21][22] We hypothesized that noncrosslinked PADM would be safe and effective when used as an onlay reinforcement of components separation repair of ventral hernias in obese patients at high risk for hernia recurrence and/or SSO.…”

Section: Introductionmentioning

confidence: 99%

A Modified Approach to Component Separation Using Biologic Graft as a Load-Sharing Onlay Reinforcement for the Repair of Complex Ventral Hernia

et al. 2013

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Background. Components separation has been proposed as a means to close large ventral hernia without undue tension. We report a modification on open components separation that allows for the incorporation of onlaid noncrosslinked porcine acellular dermal matrix (Strattice, LifeCell Corp, Branchburg, NJ) as a load-sharing structure. Methods. This was a retrospective case series including all cases using Strattice from July 2008 through December 2009. Data evaluated included patient demographics, comorbidities associated with risk of recurrence, hernia grade, and postoperative complications. The primary outcomes were hernia recurrence and surgical site occurrences. Results. There were 58 patients; 60.8% presented with a recurrent incisional hernia. Average length of follow-up was 384 days. There were 4 hernia recurrences (7.9%). Complications included surgical site infection (20.7%), seroma (15.5%), and hematoma (5%) requiring intervention. Four deaths occurred in the series due to causes unrelated to the hernia repair, only 1 within 30 days of operation. Conclusions. This series demonstrates that components separation reinforced with noncrosslinked porcine acellular dermal matrix onlay is an efficacious, single-stage repair with a low rate of recurrence and surgical site occurrences.

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Use of human acellular dermal matrix in complex and contaminated abdominal wall reconstructions

Cited by 199 publications

References 16 publications

An engineered muscle flap for reconstruction of large soft tissue defects

An engineered muscle flap for reconstruction of large soft tissue defects

Reconstruction of Abdominal Wall Musculofascial Defects with Small Intestinal Submucosa Scaffolds Seeded with Tenocytes in Rats

A Modified Approach to Component Separation Using Biologic Graft as a Load-Sharing Onlay Reinforcement for the Repair of Complex Ventral Hernia

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